Orthopedic apparatus having an improved joint construction



Jan. 25, 1966 c. REYES TERRON 3,230,952

ORTHOPEDIC APPARATUS HAVING AN IMPROVED JOINT CONSTRUCTION Filed March5, 1963 3 Sheets-Sheet 1 INVENTOR CANDIDO REYES TEE/FUN Zn KM Attfs.

Jan. 25, 1966 ,c. REYES TERRON 3,230,952

ORTHOPEDIC APPARATUS HAVING AN IMPROVED JOINT CONSTRUCTION Filed March5, 1963 3 Sheets-Sheet z INVENTOR CAND? 0o REYES TERRON ways.

Jan. 25, 1966 c. REYES TERRON ORTHOPEDIC APPARATUS HAVING AN IMPROVEDJOINT CONSTRUCTION Filed March 5.

3 Sheets-Sheet 5 INVENTOR CANDiDO REYES TERRON ATTORNEYS United StatesPatent s 8 Claims. for. 128-80) The present invention relates toimprovements in orthopedic apparatuses or appliances and the primaryobject of the present application is to provide new and novelimprovements in the joints of orthopedic appliances, particularly inappliances designed for aid in the recuperation of a patient afilictedwith paralysis, deformations, etc.

This recuperation may be attained by means of treatment in three phasesor stages:

In the first phase, an entirely rigid appliance is recommended. If theappliance used has a certain degree of free play in the joints betweenits different components or parts, such joints should be permanentlyblocked by some means which may prove most suited for this purpose.

In the second phase, a certain amount of free play may be imparted tothe joints, but this free play should be limited in degree in accordancewith the particular case.

In the third phase, the joints have a free play corresponding to thenatural movements of the anatomic joints of a patients limb.

The technique of longest acceptance is that of accomplishing each one ofthese three phases or stages by using different appliances for eachstage, such appliances being constructed in accordance with the requireddegrees of relative joint movement in each case. This technique is bothexpensive and troublesome, and is now mostly unused.

Subsequent solutions have been proposed which involve adopting the formof joints with free play between wide limits, the degree of free playbeing controlled by means of regulatory cams, which control the angle ofplay or block the joint completely.

These solutions may be considered satisfactory, since when applied, forexample, to hip or knee joints of a given appliance, they permit ofcoverage of the three mentioned phases by means of variation of theposition of the cams with respect to other parts or elements of thejoint.

Nevertheless, there are certain disadvantages which have not beensatisfactorily resolved up to the present time, and which give rise tofaults and defects in operational use.

This invention relates to novel improvements in the joints of orthopedicappliances which permit of safer operation or use by a patient of suchappliances, greater mechanical solidity for the same weight, and bettersuiting or matching of appliance joints to those of a patients limbs.Furthermore, truly impressive results are obtained in the use ofappliances on both legs.

A detailed description of these improvements is set forth in thefollowing description with respect to the attached drawings, whichillustrate a preferred form of the present invention, variations beingpossible without radical alteration of design.

In the said drawings:

FIG. 1 is a side elevational view of an orthopedic appliance, inaccordance with the present invention, for recuperation of legmovements, showing the same at maximum extension and with all cams inposition for complete blocking of the joints.

FIG. 2 is a detailed side elevational View of the hip and knee zoneportions of the appliance, showing the cams in correct position forlimited play of the joints,

"ice

FIG. 3 is a view similar to FIG. 2 but showing the cams in position forfree play of the joints.

FIGS. 4, 5 and 6, are fragmentary side elevational views of the hip,knee and ankle joints respectively.

FIG. 7 is a perspective view of a foot support associated with theappliance.

FIG. 8 is a longitudinal sectional view of the foot support, shown inFIG. 7, and,

FIG. 9 is a perspective view of an orthopedic appliance, made inaccordance with the present invention for use with both legs of apatient.

Referring now more particularly to the accompanying drawings, an upperband or clasp 1, as shown partially in FIGS. 13 and fully in FIG. 9, isprovided to engage or encircle the waist of a patient so as to hold theappliance in position.

A frame bar or brace member 2 is fixedly attached to the band 1 by meansof rivets, welding or other appropriate means and the frame bar extendsdownwardly from the band so as to be disposed along the side of apatient from the waist to the hip joint of the patients leg. The framebar is inclined outwardly at the correct angle, from the band, down to apoint adjacent the hip joint of the patients leg. A frame bar or bracemeans 3 is joined, at its upper end, for relative rotation with the bar2 by the joint construction of the present invention, to the lower endof the bar 2 and extends down to the knee joint of a patients leg, alongthe thigh of the patients leg. A frame bar or brace member 4 is securelyattached to a companion frame bar 5, so that the bars 4 and 5 constitutea single, extensible brace bar member or means, which extends along thecalf of a patients leg down to the patients ankle. The lower end of thebar 5 is attached by an articulation joint to a bar 6, which supportsand holds a foot support 7, on which the foot of a patient rests andwhich acts as a support for the patients foot.

Generally stated, as can be seen in FIG. 1 of the drawings, the bracebars or members are in a common plane and are joined together forrelative rotational movement by joints. Each joint consists of a partrigidly attached to the one end of a brace bar or member and rotatablyattached to the adjoining end of an adjoining brace bar or member. Thus,the hip joint A has a part 8, which is fixedly attached to the upper endof the brace bar or member 3, with the lower end of the brace bar ormember 2 being attached thereto in a manner permitting relativerotational movement between the bars so that the bar 3 can swing intovarious positions. The part 9 of the knee joint B is firmly attached tothe upper end of the brace bar or member 4, while the brace bar ormember 3, is rotatably associated therewith so that the member 4 canswing relative to the member 3. Thesame applies with respect to the part10, which connects the members 5 and 6 and permits relative rotationalmovement therebetween so that the member 6 can swingrelative to themember 5.

The upper and lower ends of the brace bars or members 4 and 5 overlap,as shown at 11, in FIG. 1. The overlapping portions of said bars ormembers are formed with transversely alignable holes through whichscrews 12 may be passed to secure the two parts in adjusted lengthwisepositions. Thus, the length of the unit, defined by the parts 4 and 5,that is the calf section of the appliance, can be adjusted, so as toaccommodate the length of the parts 4 and 5, composing the calf portionof the appliance, to the distance between the ankle and knee joint of aparticular patient. The bars 4 and 5 constitute a single, longitudinallyextensible brace means of the sectionalbar 3 are formed with holes,which are transversely alignable to receive screws 14. The screws 14 areused, also, to secure a thigh engaging clamp 15 to the bar or bracemember 3. The thigh embracing member or clamp 15 is shown partially inFIG. 1 and completely in FIG. 9 and the purpose thereof is to hold thebar or brace member 3 alongside the thigh of the leg of a patient.

A clamp 16, as shown partially in FIG. 1 and completely in FIG. 9, isattached to the bar 4 and is pro vided to engage the calf of the leg ofa patient so as to hold the bar or brace member 4 in position along theleg of the patient between the knee and ankle joints.

A cam 17 is associated with the hip joint A and a similar cam 18 isassociated with the knee joint B, while the ankle joint C is formed in alightly dissimilar manner. The construction and operation of the cams,in relation 'with the joint assemblies A and B will be describedhereinafter.

Each one of the three joints A, B and C has a different scope for freeplay and different angular relationship of the various components orbrace means or bars of the appliance but the operational principal issubstantially the same in each case. The brace bars or members 2, 3 and4, 5 which extend between the waistband 1 and the 'foot support 7, liein a common plane and are of the same thickness and are connectedtogether by the joints A, B and C. Generally stated, the upper endportion of any one of the bars, composing any particular joint, hasfixed, on its opposing sides, plates which are parallel to another. Theplates are fixed to the upper end portions of each downwardly succeedingbrace bar or member and extend beyond the terminal ends of the upper endportions of the brace bars to provide a space in which the lower end ofthe immediately adjoining, upwardly succeeding, brace bar or member isfitted with the bars being mounted for relative rotational movementabout a transverse pivot extending between the plates. Such a jointarrangement would be subject to the disadvantage of having the pivotssupport an excessive work load. In order to overcome this disadvantage,the lower end of an upper brace bar, which is disposed in the spacebetween the plates, is provided with means which the upper end of theimmediately adjoining, downwardly succeeding, brace bar slidably engagesby virtue of a means on the upper end complemental to the means on thelower end of an upper brace bar. In order to have this support remainconstant, regardless of the diiferent relative rotational positions ofthe jointed brace bars or members, support surfaces are formed on theterminal end portions of adjoining brace bars or members in the form ofan arc of circumference with its center in that of joint rotation. Theare formed on the lower terminal end of an upper brace bar is convex andthat formed on the adjoining terminal end of the upper end portion of abrace bar is concave.

To limit the relative rotation of the brace bars, about the pivots, thearcs are arranged in a particular manner and stop means is provided, aswill be described.

Thus, with respect to the hip joint A, as illustrated in detail in FIG.4, fiat plates 8, of corresponding shape, are attached to the oppositeside faces of the upper end portion of the brace bar 3, which extendsalong the thigh of the leg of a patient. The plates are attached to theend portion of the brace bar 3 by rivets 24 and project outwardly andforwardly from the brace bar, with respect to the positioning of thebrace bar along the thigh portion of the leg of a patient. Theprojecting portions of the companion plates 8 define wings, with a spacetherebetween in which the lower end 19 of the connection bar 2 isdisposed. The lower end 19 of the connection bar terminates in the formof an arc of con-vex circle 19a, which. compleme 1ts the cavity of thearc of circle formed laterally at the upper terminal end of the upperend portion of the brace bar 3. The plates 8 establish a relativerotational movement between the brace bars 2 and 3 by virtue of a pivot22, which extends transversely through the lower end 19 of theconnection bar 2 and passes through the plates and is maintained inposition by means of exterior heads 23. Thus, the members or bars 2 and3 are disposed for relative rotational movement, with the brace bar 3swinging about the axis 22, since the member or bar 2 is held in a fixedposition by virtue of its fixed upper end portion, which is attached tothe waist band 1. Stop means is provided for limiting the free playbetween the members or bars 2 and 3, .in accordance with the normalanatomical movement of the hip joint of the patients leg. The stop meansincludes stops 20 and 121, formed on the connection bar 2. In thisrespect, the end portion of the connection bar 2, at one end of thearcua'te edge 19a, is formed with a straight line section 20 and theother end of the arc 19a terminates with a further straight line section21. The section 2%) abuts the side edge 3a of the brace bar 3 and thesection 21 abuts the straight, terminal edge portion 312 of the bracebar 3., such straight 'line portion 3b extending laterally of theconcavity '25. It can thus be seen that the movement of the brace bar 3about the axis 2 2 in a clockwise direction will be limited by theabutting engagement of the stops 20 and 3a, while movement of the bracebar 3 in a curvilinear swinging fashion about the axis 22 and in acounterclockwise direction, will be limited by the abutting engagementof the stops 21 and 3b. The plates are suitably biased in order to placethe axis 22 of the joint A somewhat out of line with respect to the hipjoint or" the patients limb. One of the plates is provided, at the pointmost removed from the brace bar 3, with a flattened or beveledprojection or tooth 8a for cooperation with the cam 17, as will befurther described.

The knee joint B, as shown in detail in FIG. 5, is substantially similarto the joint A, except for required differences in term, commensuratewith the anatomical construction of a knee joint. Flat plates 9, whichare of kidney-shaped outline, such as the plates 8, are practically inalignment with the brace bar 4 and are fixed thereto by means of rivets31. The plates, which are in parallel relation, project upwardly andoutwardly from the end portion of the brace bar 4, in substantialalignment therewith and the projecting, spaced apart portions,constitute ears, which define a space therebetween to receive the lowerend of the brace bar 3. The brace bar 3 has a lower terminal end 245,which is provided with an arc of circumference 26a, at its terminaledge, that mates perfectly with the concavity 32 formed in the terminalend of the upper end portionof the brace bar 4. The ends of the arcuateterminal end 26 of the 'end portion of the brace bar 3 terminates instops 27 and 28, the stop 27 being formed at one end of the arc andbeing arranged at an angle, relative to the longitudinal axis of thebrace bar 3, while the stop 28 is formed, at the other end of the arcand is disposed, transversely to the axis of the brace bar 3. In thecenter of the arcuate end portion 26, inwardly of the arcuate terminaledge 2612, a pivot 29 extends transversely through the terminal endportion of the brace bar 3 and through the plates 9, with the outer endsof the pivot having threaded heads 3!). The are 32 terminates at itsrear end in a radial, descending straight stop 33, while a pin 34disposed transversely between the plates 9 acts as a stop for the frontsection or stop 28. Thus, contact between the stops 28 and 34 isequivalent to .the position for extension of the patients leg, whilecontact between the stops 27 and 23 correspond to maximum flexi-on.

One of the two plates 9 is provided with a flattened and beveled toothor projection 9a on its upper part for cooperation with the cam 18, aswill be further described.

The ankle joint C, as shown in detail in FIG. 6, is much simpler but isconstructed in accordance with the same basic principles, as the jointsA and B. Two identical plates 10 are secured by rivets 40 on theopposite sides of faces of the bar 6 and project upwardly therefrom in asubstantial alignment therewith. The lower end 3 5 of the brace bar 5terminates in an arc of circumference 35a with its center on the axis ofsymmetry of .the brace bar 5. The upper end 39 of the bar 6 is formedwith an arc of concavity 69a. The arcs 35a and 39a slide adjacent oneanother, permitting relative rotational movement be tween the brace bars5 and 6. In this respect, a pivot pin 37 is transversely disposedthrough the lower end of the brace bar 5 and through the opposing,complemental plate-s 10. Thus, the brace bar 6 is free to swing aboutthe axis 37 but such curvilinear, swinging movement is limited by theengagement of stops 37, which are pro vided at both ends of the arcs 35aand 39a and arranged, transverse to the longitudinal axis of the bracebars 5 and 6.

The provision and arrangement of complemental convex and concaveslidably engaging arcs on the contacting terminal end portions of thebrace bars permits a relative, sliding, rotational movement between thebrace bars. Such arrangement has been conceived with a view tosimplification of the structure of the joints, without diminishing theirefliciency or solidity. A major factor, in this re spect, resides in theduplication of the lateral plates, which serve as guide means andpivotally join the terminal end portions of adjacent brace barstogether. Because of the structure of the appliance, direct frictionbetween the arcs does not cause any impedance in movement of brace bars,nor does it tend to produce any substantial wear and tear which wouldreduce the longevity of use of the appliance. Of course, any addition tothe joints, as described, such as in the form of conventional rollerappliances or the like, can be employed and would fall within theconcept of the joint construction of the present application.

This is evident, and all the more so, since the joints described arethose which can most simply be provided within the concept of thepresent invention and are designed for maximum simplicity and economywithout impairment of quality standards, as required in practicaloperation.

As has been described and can be seen, each joint has its angle of freeplay limited within the normal limits of rotation of the correspondinganatomical joint of the patient, by virtue of the stop means,structurally associated with each of the joints A, B and C. Insofar asthe hip and knee joints are concerned, the limits indicated correspondto the positions of the cams 17 and 18, in which they do not evenpartially block the relative rotational movement.

There is, between this position of completely free rotation and that oftotal locking of rotation, between the various brace bars, anintermediate position for the cams, in which the cams block the movementof the joints between more reduced limits than those indicated. Theselimits,-as shown in FIG. 2, are determined for each case in accordancewith the recommendations of a specialist, based on .the characteristicsof the patient and the particular orthopedic incapacity.

.The cams 17 and 18, respectively, rotate on the brace bars 2 and 3 andare pivotally or rotatably mounted on such brace bars, adjacent theplates 8 and 9 and on the same side of the brace bars on which theplates 8 and 9, which are formed with the projections or teeth 8a and18a are disposed. The cams are pivotally mounted on the brace bars 2 and3 by means of bolts or pivots having outer heads 41 and 42.

The cams are of approximately isosceles triangular formation withnotches 17a and 17b in the cam 17 and notches 18a and 18b in cam 18formed at the ends of the bases of the triangular cams. The pivots forthe cams are disposed, adjacent the base portions, intermediate thenotches. The projecting teeth 8a and 9a on one of the plates 8 and onone of the plates 9 cooperate with the notches 17a and 17b on the cam 17and with the notches 18a and 18b on the cam 18 in order to lock thebrace bars,,

6 in an immobile position, as shown in FIG. 1, and to per mit a limitedfree play movement, as shown in FIG. 2, while the cams are positioned,as shown in FIG. 3, to permit the unlimited free play movement o-f-thebrace bars, in accordance with'the anatomical movements of the leg of apatient, but subject to the stop means, as shown in FIGS. 4 -6. The formof the bases of the cams and of the notches, provided at the ends of thefaces with respect to the relative rotational movement between the bracemembers 3 and 4 and the brace member or bar 3 and the bar 2, are suchthat, for the first position shown in FIG. 3, the teeth 8a and 9a do notcome into contact with the notches,so that there is unlimited free playbetween the brace bars 3 and 4 and between the brace bar 3 and the bar2. By employing a rotary movement to each one of the earns 17 and 18, ineither direction, as may be appreciated from a consideration of FIGS. 1and 2, one or the other of the notches 17a, 17b and 18a, 18b is broughtinto contact with .the teeth or projections 8a, 9a on one of the plates8 and The notches 17a and 18a are formed, in such a manner as tocomplement the lateral formation of the projections or teeth 8a and 9a,whereby the brace bars 3 and 4 are locked, against relative rotationalmovement, and the brace bar 3 is locked against rotary movement,relative to the bar 2. Thus, the bars 2, 3 and 45, are held in astraight line position, in a com.- mon plane, extended down alongsidethe leg of a patient and preventing any movement of the anatomical hipor knee joints of the patients leg. The notches 17b and 18b have sides,arranged in an obtuse angle, while the notches 17a and 18a have sides,arranged at right angles. The right angular relationship of the sides ofthe notches 17a and 18a, complements the square configurations of theends of the projections or teeth on the plates, so as to preventrelative rotational movement, as shown in FIG. 1.

On the other hand, as shown in FIG. 2, when the cams are moved into thepositions, as shown in FIG. 2, the projections or teeth engage thenotches 17b and 18b, which leaves a small angular gap, therebypermitting a limited movement.

Pivots 43 and 45 are provided at the apexes of the cams 17 and 18,opposite to the faces, and pivots 46 and 47 are provided on the thighand calf clamps 15 and 16. Elastic elements such as the rubber bands 43aand 45a, extend between such pivots for the placement of the cams incorrect positions for each case, the tension exerted leading to aneasier operation of the cams. While bands 43 and 45a are illustrated, itis obvious that other tension means, such as springs or the like may beutilized for this purpose.

For the purpose of exerting an elastic tension on the ankle joint C, apivot 48 is provided and may be inserted through one of the overlappingportions 4-5. An elastic band 11a extends between the pivot 48 and thefront part of the foot support 7. Y

All of the brace bars or other parts of the appliance which, on accountof their special form, may come in contact with the patients body andcause the patient discomfort, are provided on their interior surfaceswith protection in the form of cushioning pads (not shown).

Reference is now made in FIGS. 7 and 8, wherein a modified form of footsupport is shown. The insole 7', which is made of resistant material,such as metal or the like, is provided on the planter arch portion withtransverse axis rod 49 to which the lower ends of a pair of upstandingbars 52 are attached at their lower ends. In. the zone of the heel ofthe underpart of the foot support 7', a hook 50 is provided in order-toattach the foot supports to a flexible tiebar or strip 51 which limitsthe rota tion of the underpart of the foot about the axis 49. Since thetie bar is flexible, the hook 50 may be rigid and merely secure the heelportion of the-foot support '7 to the bottom of the part 51. The part 51is a flexible brace, which fulfills the function of the Achilles tendon.Its upper end may be attached to a part of the appliance.

Thus,'by means of transversal to-and-fro movement, the patient may makewalking progress, even though his leg muscles are not used in thefashion normally associated with such progress.

FIG. 9 shows an orthopedic apparatus, which combines the features of thepresent invention, but in which there are not shown all of the detailsdescribed in the previous figures. In FIG. 9, the orthopedic apparatusis made to be attached to the two legs of a patient.

The joint 54 of the foot support 7", in FIG. 9, is made up of an axis inthe form of a prolongation of the end of the brace bars the lateralprolongations being fitted in transverse bores in the other sides of thefoot support 7".

Flexible strips or hands 51, which can be flexed but are not elastic, sothat they cannot be lengthened, extend between the foot supports 7" andthe calf clamps 16' and similarly formed strips 53 extend between theclamps 16' and the calf clamps and are provided for limitation ofmovement of the knee joint B.

The combination of the elastic tractions with respect to the ankle andknee joints, and limitation of the compound movement by means offlexible straps, enables a patient, to whom the appliance of FIG. 9 hasbeen fitted, to make walking progress, even in cases where patients havetotal paralysis of the lower limbs. The patient rests first on one footsupport and then on the other and by means of a transversal to-and-fromovement, an impulse for movement in a forward direction of the devicefitted to the free leg is given. Thus, while the patients one paralyzedleg rests on one of the foot supports 7", which is on the ground, theother leg is caused to move forward in a forward direction and,following through, by means of a transversal to-and-fro movement, thepatient is able to move forwardly.

I claim:

1. In an orthopedic apparatus which includes a pair of brace memberslying in end to end relation in a common plane and adapted to bedisposed alongside of the jointed portions of a patients limb and eachhaving means adapted to engage the limb portion that it is disposedalongside of and each having opposing sides and said brace membershaving adjoining ends; a joint means connecting the adjoining ends ofthe brace members'and adapted to be disposed alongside the anatomicjoint between the portions of the patients limb; said joint meansincluding terminal ends on the adjoining end portions of the bracemembers, complemental means on said terminal ends to accommodaterelative rotational movement be tween the brace members, guide platesoverlapping the. end portions of said brace members on both sides of thebrace members, said guide plates being fixed to the sides of the endportion of one brace member and projecting therefrom, the adjoining endportion of the other brace member being disposed between the projectingportions of the guide plates, means pivotally mounting the guide platesto the end portion disposed therebetween of the other brace member,whereby relative rotational movement between the brace members ispermitted, a cam having an end portion, pivot means pivotally mountingthe cam on one of the sides of the end portion of one of the bracemembers, said end portion of the cam having laterally spaced apart notchmeans on opposite sides of the pivot means, the guide plate on thecorresponding side of the brace members with the cam having a projectingtooth selectively engageable with the notch means, one of said notchmeans receiving the tooth to lock the brace members in a straight lineimmobile position, the other of said notch means receiving the tooth topermit limited rotational play of the brace members about the meanspivotally connecting the guide plates to the onebrace member in onedirection corresponding to the normal directional swinging movement ofthe portions of the patients limb, the cam being movable about the pivotmeans into a position where the tooth is free from engagement witheither of the notch means, thereby permitting free relative rotationalplay between the brace members in said direction corresponding to thenormal directional swinging movement of the portions of the patientslimb, step means for limiting said last relative movement of the bracemembers to a degree equivalent to the movement of the anatomic jointbetween the portions of the patients limb and means for securing the camin each of said positions.

2. The invention of claim 1 wherein said complemental means on theterminal ends of the end portions of the brace members includes saidterminal ends which lie in a common plane, having edges respectivelyshaped as a concave and a convex are having the same radius with the arcshaped edges slideably engaging each other and the pivot'means pivotallymounting the guide plates to the end portion of the other brace memberincluding a transverse pivot which coincides with the center of saidarcs.

3. The invention of claim 2., wherein said stop means includes straightportions formed in angular relation to the are shaped edges on aterminal end and disposed at the ends of the concave and convex arcs andadapted to form abutment surfaces.

4. An orthopedic apparatus for use with a leg of a patient comprisingmeans adapted to engage the waist of a patient, a connection membersecured to the waist engaging means and inclined downwardly andoutwardly and adapted to extend to a point alongside the hip of apatient, a first brace member adapted to lie alongside the side portionof a leg of a patient and having means adapted to engage the thigh ofthe leg of a patient, a hip joint means connecting the upper end portionof said first brace member and said connection member in the vicinity ofthe anatomic hip joint of the leg of a patient, a second brace memberadapted to extend alongside the calf of the leg of a patient and havingmeans adapted to engage the calf of the leg of a patient, said firstbrace member having a lower end portion and said second brace memberhaving an upper end portion disposed in the vicinity of the anatomicknee joint of a patient, a knee joint means connecting said end portionsof said first and second brace members in the vicinity of the anatomicknee joint of the leg of a patient, a foot support on which the foot ofa patient is adapted to rest, means pivotally attaching the foot supportto the second brace member, said hip and knee joints including adjoiningend portions on said members, said adjoining end portions havingterminal edges respectively shaped as a concave and a convex are havingthe same radius, the said arc shaped edges lying in a common plane andslideably engaging each other, guide plates overlapping the adjoiningend portions of the members, means securing said guide plates to the endportion of one of said adjoining members, a pivot which coincides withthe center of said arcs traversing said guide plates and the adjoiningend portion of the adjoining member, a cam pivotedly mounted on one ofthe members and having an end portion provided with laterally spacednotch means on opposite sides of the pivot, the guide plate on thecorresponding side of said member with the cam having a projectingtooth, selectively received by the notch means, one of said notch meansreceiving the tooth to lock all of the members in a straight lineimmobile position, the other of said notch means receiving the tooth topermit limited rotational play of the members in one directioncorresponding to the normal directional swinging movement of theportions of the leg of a patient, the cam being,

movable into a position about the pivotal mounts where the tooth is freefrom engagement with either of the notch means, thereby permitting freerotational play between the members in said direction corresponding tothe normal directional swinging movement of the portions of the patientsleg, and stop means for limiting said free play in accordance with themovement of the anatomic hip and knee joints of the patients leg andmeans for securing the cam in each of said positions.

5. The invention of claim 4, wherein said stop means includes abutmentsurfaces on said terminal ends of the members for cooperation with stopsto limit the relative rotation of said members.

6. The invention of claim 4, wherein said means attaching the footsupport to the second brace member includes an ankle joint, said anklejoint including an upstanding bar secured to the foot support, andhaving an upper terminal end portion, said second brace member having alower end portion, said end portions of the second brace member and saidbar having terminal ends having edges respectively shaped as a concaveand a convex arc having the same radius, guide plates overlapping theadjoining end portions of the adjoining ends of the second brace memberand the bar, means fixing said plates to the bar, means pivotallymounting the plates to the end portion of the second brace member forrelative rotational movement and stop means limiting the relativerotational movement.

7. The invention of claim 4, wherein said means attaching the footsupport to the brace member includes a pivotal joint and a flexiblestrap of non-extendable material and fixed at one end to the rear ofsaid foot support and attached at the other end to an upper part of theapparatus to act as an Achilles tendon.

8. The invention of claim 4, wherein said foot support is joined by anankle joint to the second brace member, a strap of flexible andnon-extendable material attached to rear portions of the brace members,and to the foot support, whereby they form a tendon which causes forwardmovement of the lower part of the apparatus when it is freed of thepatients weight.

References Cited by the Examiner UNITED STATES PATENTS 1,939,097 12/1933Bauman 128-80 2,267,848 12/1941 Taylor 128-80 2,413,634 12/1946 Kolarik128-80 2,558,986 7/1951 Seelert 128-80 2,632,440 3/ 1953 Hauser et al128-80 2,646,793 7/1953 Swiech et a1 128-80 2,877,033 3/1959 Koetke128-80 X 3,042,028 7/1962 lller 128-80 FOREIGN PATENTS 412,362 4/ 1925Germany.

227,286 1/1925 Great Britain.

830,507 3/1960 Great Britain.

RICHARD A. GAUDET, Primary Examiner.

JAMES W. HINEY, JR., Assistant Examiner.

1. IN AN ORTHOPEDIC APPARATUS WHICH INCLUDES A PAIR OF BRACE MEMBERSLYING IN END TO END RELATION IN A COMMON PLANE AND ADAPTED TO BEDISPOSED ALONGSIDE OF THE JOINTED PORTIONS OF A PATIENT''S LIMB AND EACHHAVING MEANS ADAPTED TO ENGAGE THE LIMB PORTION THAT IT IS DISPOSEDALONGSIDE OF AND EACH HAVING OPPOSING SIDES AND SAID BRACE MEMBER HAVINGADJOINING ENDS; A JOINT MEANS CONNECTING THE ADJOINING ENDS OF THE BRACEMEMBERS AND ADAPTED TO BE DISPOSED ALONGSIDE THE ANATOMIC JOINT BETWEENTHE PORTIONS OF THE PATIENT''S LIMB; SAID JOINT MEANS INCLUDING TERMINALENDS ON THE ADJOINING END PORTIONS OF THE BRACE MEMBERS, COMPLEMENTALMEANS ON SAID TERMINAL ENDS TO ACCOMMODATE RELATIVE ROTATIONAL MOVEMENTBETWEEN THE BRACE MEMBERS, GUIDE PLATES OVERLAPPING THE END PORTIONS OFSAID BRACE MEMBERS ON BOTH SIDES OF THE BRACE MEMBERS, SAID GUIDE PLATESBEING FIXED TO THE SIDES OF THE END PORTION OF ONE BRACE MEMBER ANDPROJECTING THEREFROM, THE ADJOINING END PORTION OF THE OTHER BRACEMEMBER BEING DISPOSED BETWEEN THE PROJECTING PORTIONS OF THE GUIDEPLATES, MEANS PIVOTALLY MOUNTING THE GUIDE PLATES TO THE END PORTIONDISPOSED THEREBETWEEN OF THE OTHER BRACE MEMBER, WHEREBY RELATIVEROTATIONAL MOVEMENT BETWEEN THE BRACE MEMBERS IS PERMITTED, A CAM HAVINGAN END PORTION, PIVOT MEANS PIVOTALLY MOUNTING THE CAM ON ONE OF THESIDES OF THE END PORTION OF ONE OF THE BRACE MEMBERS, SAID END PORTIONOF THE CAM HAVING LATERALLY SPACED APART NOTCH MEANS ON OPPOSITE SIDESOF THE PIVOT MEANS, THE GUIDE PLATE ON THE CORRESPONDING SIDE OF THEBRACE MEMBERS WITH THE CAM HAVING A PROJECTING TOOTH SELECTIVELYENGAGEABLE WITH THE NOTCH MEANS, ONE OF SAID NOTCH MEANS RECEIVING THETOOTH TO LOCK THE BRACE MEMBERS IN A STRAIGHT LINE IMMOBILE POSITION,THE OTHER OF SAID NOTCH MEANS RECEIVING THE TOOTH TO PERMIT LIMITEDROTATIONAL PLAY OF THE BRACE MEMBERS ABOUT THE MEANS PIV-